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Raghid El Yafouri

DBA Graduate - 2015

Thesis title

Electronic Medical Records Adoption and Use Understanding the Barriers and the Levels of Adoption for Physicians in the USA


Leslie Klieb

Raghid has 19 years of professional experience in strategic planning, business analysis, system architecture, application development, project management, and digital advertising. He excels in crafting best practice solutions that blend business theory and real-world applications. He has worked with clients in the automotive, financial, healthcare, education, retail, hospitality and entertainment industries including Chrysler, GM, Ford, Comerica, Prudential, Pfizer, and Johnson Controls.

Through an empirical study, this paper presents a model which identifies the factors that impact the intention and decision of physicians in the USA to adopt and use EMR systems in efforts to enhance the quality and reduce the costs of health care nationwide. The EMR Planned Adoption Model introduces a multi-stage EMR system diffusion where the decision can be for implementing a system for the first time or advancing the implementation through the adoption of a subsequent level of the system. Consistent with the Theory of Planned Behavior, the decision on EMR adoption is impacted by the intention (motivation) and the confidence (perceived behavioral control) of physicians in the system. The intention itself is impacted by attitude, confidence (perceived behavioral control) and government influence (subjective norm). Attitude is the strongest influencer of intention and the influence of government on a physician’s intention is marginal which reflects that physicians do not value subjective norm in general and the government mandate in particular when deciding to adopt an EMR system. Factors that influence attitude include peer perception, knowledge and perceived industry benefits while confidence is influenced by exposure to EMR system levels, ease of acquisition and operational disruption control. More than a third of the physicians (36 percent) reported that their practices have the highest level of EMR system adoption and 7 percent said that they have no form of a computerized system for the management of their medical records in their practices.